Are We Letting Our Patients Suffer?

traumaRUs
has 25 years experience as
a MSN, APRN and
works as a Asst Community Manager @ allnurses.

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The title says it all - has the pendulum swung the opposite way? Are we providing adequate pain relief for our patients or holding back for fear of addiction? You are reading page 5 of Are We Letting Our Patients Suffer?. If you want to start from the beginning Go to First Page.

Yes, absolutely the pendulum has swung too far. Unfortunately many innocent patients have been impacted in the government's war on opiates. My own mother in fact, who has chronic degenerative osteoarthritis and is in a physician monitored chronic pain management program. Anyone on long term chronic pain medication will develop physical dependency, and we have to deal with this issue every time she goes into the hospital. We always explain her pain management program regimen, and share the information with everyone who is responsible for her care, from the physicians to her nurses, all of it a waste every time. They refuse to order her any pain medication, and in order to avoid withdrawals, she has to keep her home meds with her, hidden from the hospital staff. Her pain management doctor has had to reduce her dosage 3 times in order to comply with DEA regulations because the government has decided what constitutes a proper dose of narcotic. He told my parents a government agent visited his practice and told him he was "abusing" his patients. He said he had never been spoken to in such a manner before. Here he is, devoting his career trying to help people lead better quality lives and he's being accused of being a sleazy pill pusher.

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SafetyNurse1968
has 20 years experience as a ADN, BSN, MSN, PhD and works as a Assistant Professor.

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I'm so glad someone has the courage to talk about the other side of the war on opioids. I'm teaching patient centered care to brand new nursing students, and these new laws on pain medications violate everything we are teaching new nurses: treat the patient, pain is what the patient says it is. I know we are trying to find alternatives to opioids, but it can be very difficult to do patient centered care in the face of these new laws. The stories ya'll have posted are heart breaking. We have to advocate for our profession. Join the ANA, donate to the PAC and speak out. It's great to see your voices here on allnurses.com, but we MUST speak up in public and political forums if we want things to change. Only 3% of nurses are politically active. Imagine what we could accomplish if it were 90%?

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I'm teaching patient centered care to brand new nursing students, and these new laws on pain medications violate everything we are teaching new nurses: treat the patient, pain is what the patient says it is.

I'm not sure that this is how we should be teaching nursing students, perhaps it is time for nursing to update the way we think about pain management to be more dynamic and patient-centered than just having pain be pain.

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Her pain management doctor has had to reduce her dosage 3 times in order to comply with DEA regulations because the government has decided what constitutes a proper dose of narcotic.

The DEA does not have any regulations that limit the dosing of CSII meds. There may be state regulations or insurance quantity limits that impact this. Also, it is important to note, trial dose reductions are recommended at regular intervals to ensure patients remain on the lowest possible effective dose.

I've heard that anti-anxiety medications are next in this war.

Beznodiazepines are also addictive, associated with poor outcomes especially in the elderly, and vastly over/inappropriately prescribed.

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this thread was too pain for me to participate in when it first came up. in fact i a crying now. i lost a looong term friend to this undermedication issue several days before it was started. try getting tylenol only afte a fem/fem bypass, within 12 hours of surgery, "we have to do this, it is too far after sugery to get stronger" 12 freaking hours. the patient made it home, died several days later. So, yes, tell the stupid freaky Puritanical idiots to stay away.

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traumaRUs
has 25 years experience as a MSN, APRN and works as a Asst Community Manager @ allnurses.

484 Likes;
14 Followers;
127 Articles;
184,888 Visitors;
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this thread was too pain for me to participate in when it first came up. in fact i a crying now. i lost a looong term friend to this undermedication issue several days before it was started. try getting tylenol only afte a fem/fem bypass, within 12 hours of surgery, "we have to do this, it is too far after sugery to get stronger" 12 freaking hours. the patient made it home, died several days later. So, yes, tell the stupid freaky Puritanical idiots to stay away.

I am so sorry for your loss.

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nursej22
has 30 years experience as a MSN, RN and works as a royal pain in the tuchus.

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this thread was too pain for me to participate in when it first came up. in fact i a crying now. i lost a looong term friend to this undermedication issue several days before it was started. try getting tylenol only afte a fem/fem bypass, within 12 hours of surgery, "we have to do this, it is too far after sugery to get stronger" 12 freaking hours. the patient made it home, died several days later. So, yes, tell the stupid freaky Puritanical idiots to stay away.

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Here is my current situation and I'm sorry for going on about this. I have a torn left rotator cuff. I also have C4-C7 bulging and prolapsed docs causing nerve root compression of several nerves.

The shoulder doctor pulls up my narcotic history. I have taken no narcotics since November 2017. I had a csection in August of 2017, subsequent infection in my uterus at the surgical site, had a gallbladder attack in October of 2017, then gallbladder removal in November. I had to defend those narcotic scripts from 12-15 months ago.

I've been refused pain meds the past 2 months. I can't even lift my child. I haven't slept more than 4 hours a night due to the pain.

Tomorrow, I get epidural injections. I'm not allowed ibuprofen for the last 5 days leading up to the injection. Ibuprofen was all I had. Today I had a root canal. Can't take even ibuprofen.

How is this right? I've been told it can up to 2 weeks for these injections to work. I'm the grumpiest, most hateful person right now.

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